2012 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips | |||||||||||
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Plan Name | County | Monthly Prem. (Parts C & D) |
Deduct- ible |
(Donut Hole) Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance 30-Day Supply |
MOOP for Part A & B Benefits | |||||
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
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AARP MedicareComplete Choice (PPO) - H1509-001-0 Benefit Details |
Adams | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $3.00 Tier 2: $6.00 Tier 3: $45.00 Tier 4: $95.00 Tier 5: 33% | $4,400 Browse Formulary | |||||
Blue Medicare Access Value (Regional PPO) - R5941-009-0 Benefit Details |
Adams | $0.00 | $60 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $43.00 Tier 3: $85.00 Tier 4: 33% Tier 5: 33% Tier 6: $7.00 | $4,200 Browse Formulary | |||||
Humana Gold Plus H2012-028 (HMO) - H2012-028-0 Benefit Details |
Adams | $0.00 | $0 | Many Generics, Few Brands | Tier 1: $5.00 Tier 2: $40.00 Tier 3: $80.00 Tier 4: 33% | $3,600 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-066 (Regional PPO) - R5826-066-0 Benefit Details |
Adams | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
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Today's Options Premier 400 (PFFS) - H6169-012-0 Benefit Details |
Adams | $20.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
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UnitedHealthcare Dual Complete (PPO SNP) - H1509-004-0 Benefit Details |
Adams | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: 15% Tier 2: 15% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HumanaChoice H1510-005 (PPO) - H1510-005-0 Benefit Details |
Adams | $39.00 | $0 | Few Generics, Few Brands | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $85.00 Tier 4: 33% | $4,500 Browse Formulary | |||||
Blue Medicare Access Standard (Regional PPO) - R5941-003-0 Benefit Details |
Adams | $43.00 | $60 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $43.00 Tier 3: $85.00 Tier 4: 33% Tier 5: 33% Tier 6: $7.00 | $3,400 Browse Formulary | |||||
Today's Options Premier 200 (PFFS) - H6169-050-0 Benefit Details |
Adams | $50.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Today's Options Advantage Plus 450F (PPO) - H5378-184-0 Benefit Details |
Adams | $51.00 | $75 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
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Today's Options Premier Plus 450B (PFFS) - H6169-032-0 Benefit Details |
Adams | $59.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
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Humana Gold Choice H8145-011 (PFFS) - H8145-011-0 Benefit Details |
Adams | $69.00 | $0 | Few Generics, Few Brands | Tier 1: $7.00 Tier 2: $40.00 Tier 3: $82.00 Tier 4: 33% | $6,700 Browse Formulary | |||||
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Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-008 (Regional PPO) - R5826-008-0 Benefit Details |
Adams | $71.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $60.00 Tier 4: 28% | $6,700 Browse Formulary | |||||
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Today's Options Premier Plus 250A (PFFS) - H6169-054-0 Benefit Details |
Adams | $112.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
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HumanaChoice H1510-009 (PPO) - H1510-009-0 Benefit Details |
Adams | $119.00 | $0 | Few Generics, Few Brands | Tier 1: $7.00 Tier 2: $40.00 Tier 3: $80.00 Tier 4: 33% | $5,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Today's Options Advantage Plus 250A (PPO) - H5378-200-0 Benefit Details |
Adams | $122.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
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